1.
Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study.
Pérez-Belmonte, LM, Torres-Peña, JD, López-Carmona, MD, Ayala-Gutiérrez, MM, Fuentes-Jiménez, F, Jorge Huerta, L, Muñoz, JA, Rubio-Rivas, M, Madrazo, M, Garcia, MG, et al
BMC medicine. 2020;(1):359
Abstract
BACKGROUND Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. METHODS We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine's registry of COVID-19 patients (SEMI-COVID-19 Registry). It is an ongoing, observational, multicenter, nationwide cohort of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs in a 1:1 manner by propensity scores. In order to assess the adequacy of propensity score matching, we used the standardized mean difference found in patient characteristics after matching. There was considered to be a significant imbalance in the group if a standardized mean difference > 10% was found. To evaluate the association between treatment and study outcomes, both conditional logit and mixed effect logistic regressions were used when the sample size was ≥ 100. RESULTS A total of 2666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of the need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays. CONCLUSIONS In patients with type 2 diabetes mellitus admitted for COVID-19, at-home glucose-lowering drugs showed no significant association with mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed.
2.
Effect of Calcium Hydroxide on Bonding Performance of an Experimental Self-etch Adhesive.
Garcia, MG, Poskus, LT, Hass, V, Amaral, CM, Noronha-Filho, JD, Silva, EMD
The journal of adhesive dentistry. 2018;(1):57-64
Abstract
PURPOSE To investigate the effect of Ca(OH)2 concentration on pH neutralization, degree of conversion (DC%), and bonding performance of experimental self-etch adhesives (SEAs). MATERIALS AND METHODS Four different concentrations of Ca(OH)2 (0 wt%, 1 wt%, 2 wt%, and 4 wt%) were added to the bond of an experimental two-step SEA consisting of primer (10-MDP [30 wt%], TEG-DMA [30 wt%], ethanol [35 wt%], water [5 wt%], camphorquinone [0.5 wt%], and tertiary amine [0.5 wt%]) and bond (bis-GMA [50 wt%], TEG-DMA [30 wt%], HEMA [20 wt%], camphorquinone [0.5 wt%], and tertiary amine [0.5 wt%]) to form four groups: E0, E1, E2 and E4. pH neutralization was evaluated until it reached equilibrium, and DC% within the hybrid layer was analyzed by micro-Raman spectroscopy. Human molars were wet ground until the occlusal dentin was exposed, SEAs were applied, and composite buildups were constructed. After storage in distilled water at 37°C for 24 h, the teeth were cut into composite-dentin beams. Microtensile bond strength (µTBS) was evaluated after 24 h of water storage at 37°C. Nanoleakage was evaluated by SEM. Data were analyzed using ANOVA and Tukey's HSD test (a = 0.05). RESULTS All the SEAs reached pH equilibrium after thirteen days, with E1 and E4 presenting the highest pH (p < 0.05). E0 and E1 presented lower DC% than did E2 and E4 (p < 0.05). All the SEAs showed statistically similar mTBS and nanoleakage (p > 0.05). CONCLUSION The incorporation of Ca(OH)2 endowed the SEAs with pH-neutralization ability and improved their DC%, without interfering with the bond strength to dentin or nanoleakage extent.
3.
Tolerance of a sterile isotonic electrolyte solution containing select recombinant growth factors in neonates recovering from necrotizing enterocolitis.
Lima-Rogel, V, Calhoun, DA, Maheshwari, A, Torres-Montes, A, Roque-Sanchez, R, Garcia, MG, Christensen, RD
Journal of perinatology : official journal of the California Perinatal Association. 2003;(3):200-4
Abstract
OBJECTIVE To assess the tolerance of a sterile isotonic electrolyte solution containing select recombinant growth factors enterally administered in neonates who were NPO because of necrotizing enterocolitis (NEC). STUDY DESIGN A phase I trial was accomplished among 30 neonates. Patients received 5, 10, or 20 mL enterally of the study solution/kg/day divided into every 3-hour dosing, for 3 days prior to when feedings of milk were to resume. The occurrence of emesis, gastric residuals, diarrhea, bloody stools, abdominal distention, skin rashes and death were sought. RESULTS Gestational ages ranged from 25.2 to 41.1 weeks. A total of 16 neonates had Stage IA NEC, six Stage IB, and eight Stage IIA. The solution was well tolerated in all 30; none developed diarrhea, guaiac positive or bloody stools, or abdominal distention. Administration of the solution was not prematurely discontinued in any infant. Two neonates died secondary to late-onset sepsis remote from the study period. CONCLUSIONS Enteral administration of a sterile isotonic electrolyte solution containing select recombinant growth factors was well tolerated by neonates with NEC.